Recently I was reading an article about the usefulness of evolutionary perspective in medical sciences and was struck by how often the changes in our social environment have ended up creating unexpected and not always beneficial side effects due to our biologal setup not being properly adapted to new environment. For example, it seems that the invention of agriculture implied less healthy diet and more diseases for most people. Naturally it also implied the possibility of dramatically higher population densities than in hunter gatherer societies, but individual well being was most likely eroded. Or another example, improvement in hygiene and sanitation is perhaps the most important public health achievement in human history, but as side effects it seems to have caused higher incidence of autoimmune diseases (allergies etc) and childhood leukemia.

Most people abhor the idea that we would genetically alter organisms, let alone ourselves, to be better adapted to the some man-made or natural environment. Often this concern is surely justified, especially when the corcern involves a demand for more careful consideration of unexpected side effects, but why is it that we rarely address the issue of social or cultural changes creating similar side effects? As is well known, our genes do not “mean” anything outside the context provided by the environment in which they act. To give rise to some effect one could imagine changing the genetic makeup and give rise to an organism with some desired “genetic” tendency. On the other hand similar effects could also be achieved by changing the environment where the genes act. An individual well adapted to some environment might suddenly find himeself/herself living in an environment which is, in a sense, incompatible with his/hers genetic makeup. Why is it that there has never been debate about, for example, forming society whose high fat diet (or availability of different drugs) is manifestly incompatible with our genetic makeup even when such society causes huge amount of unneccesary diseases unknown to our ancestors? Also, artificial lighting has enabled us to stay awake and active even when it is dark, but that additional light also influences our melatonin levels and, so it seems, increases the risk for breast cancer! What about urbanization? A city is a drastically different environment from the one humans were adapted to. What side effects does urbanization cause? We never debate such issues. It seems to be assumed that social change can be happen with people just instanteneously adapting into new environment.

Of course, such issues have not been debated in the past, because at the time decisions were taken or when changes “appeared” these side effects were unknown. The changes seemed to provide immediate advantages and were adopted without further consideration. But how would we react nowadays, if we did understand adverse side effects from societal changes? If some so-called scientist comes to us with this new “innovation” called “hygien” and tells us how it can reduce mortality, but at the same time will cause all those additional diseases for many children. Would we be able to adopt such a new innovation nowadays, if the hidden cost of the innovation were made clear? How many people would you be ready to sacrifice to leukemia for example? Could you make such a decision? If not, doesn’t it appear that it would then be more “responsible” to rush headlong into new innovations that promise immeadiate benefits as opposed to arguing about the future risks and letting such fears to prolong the suffering of the people living now? Where do we draw the line? When is our concern about risks responsible and when does this concern turn into de facto defence of status quo and continued sufferering?